Provider Demographics
NPI:1366577736
Name:GONZALEZ, NANCY (PHTEC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHTEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2008
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2008
Mailing Address - Country:US
Mailing Address - Phone:787-846-4412
Mailing Address - Fax:
Practice Address - Street 1:CARR #2 KIL 57.8
Practice Address - Street 2:CRUSE DAVILA
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-846-4412
Practice Address - Fax:787-846-7410
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician